*Denotes Required Field
*First Name:
*Last Name:
Address:
City:
State:	Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon -------------------- Other
Zip Code:
*Phone:
*Email:
Time at Address (years/months):
	Are you over 18 years of age? Yes No
	Have you ever worked at Tedeschi Food Shops, Li'l Peach, or Store 24 before? Yes No
	If you answered "yes" above, give dates and location:
Position Desired:	General Manager Assistant Manager Deli Manager Sales Associate
Location Desired: